Muhammad Wasif Saif, Daniel Gorovets, Kathryn Huber
Despite decades of research, pancreatic cancer remains essentially incurable for patients with unresectable tumors. In theUnited States, most patients with locally advanced pancreatic cancer are treated with chemotherapy alone or combined withconventionally fractionated radiotherapy. Regardless of the treatment strategy, average survival for these patients is lessthan 1 year, indicating that the current approaches are indisputably inadequate. For locally advanced pancreatic cancerpatients, effective local-regional control is not only crucial for any hope at long-term survival, but also for symptommanagement. The aim of this paper is to highlight abstracts from the 2014 ASCO Gastrointestinal Cancers Symposium thatdemonstrate the use of novel local-regional therapies in locally advanced pancreatic cancer. Abstracts #317, #328, and #361describe their results with an advanced method of delivering radiation called stereotactic body radiation therapy (SBRT). Inthese studies, patients treated with combined chemotherapy and SBRT had exceptional local control rates and acceptabletoxicity. An innovative alternative to radiation for local-regional treatment is presented in Abstract #270. This study showsencouraging results from a phase I investigation of a regionally delivered siRNA that targets the K-rasG12D mutation.Investigation of novel approaches such as those presented here holds the greatest promise for improving treatment of thisdeadly disease.
